Organization
PB & J FAMILY SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUSANNAH BURKE MS, MSW, LISW (EXEC. DIRECTOR)
(505) 877-7060
Entity
Organization
Contact information
Practice address
1101 LOPEZ RD SW, ALBUQUERQUE, NM 87105-3954
(505) 877-7060
(505) 877-7063
Mailing address
1101 LOPEZ SW, ALBUQUERQUE, NM 87105
(505) 877-7060
(505) 877-7063
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
252Y00000X
Early Intervention Provider Agency
—
NM
261QD1600X
Developmental Disabilities Clinic/Center
—
—
261QH0100X
Health Service Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000Q3467
—
NM
05
—
NM600403
—
NM
Enumeration date
01/04/2007
Last updated
01/10/2011
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